Simultaneous Pneumocystis carinii and pneumococcal pneumonia in human immunodeficiency virus-infected children.

Three children with acquired immunodeficiency syndrome who had pneumonia develop were infected simultaneously with Pneumocystis carinïi and Streptococcus pneumoniae. Such coexistence has not been previously reported in children. One patient received prophylactic treatment against Pneumocystis carinïi before his illness.

The effects of guided tissue regeneration membrane placement on healthy periodontal sites.

This study investigates the effects of the placement of a bioresorbable Type I collagen barrier on clinically healthy sites. Ten human subjects, with at least one pair of matched periodontal defects included in a previous study, were investigated for the effect of guided tissue regeneration (GTR) membrane placement on adjacent healthy sites. Control sites consisted of open flap debridement, while experimental sites consisted of similar debridement procedures with placement of a collagen membrane for GTR. The membrane placement was designed to completely cover the periodontal defect, and therefore of necessity overlapped adjacent periodontally healthy sites. It is these healthy sites that are included in the present study. Standardized measurements of change in probing attachment levels were obtained at the time of surgery and 1 year later. The differences in change of clinical attachment levels (CAL) were compared utilizing the Student t-test for paired samples. The mean loss of CAL in the control sites was 1.00 +/- 1.179 mm, and in the test sites was 0.60 +/- 1.729 mm. When comparing the difference in changes of CAL in both test and control sites, there was no statistical significance. There was, however, a wide range of changes between individual sites, which might suggest a clinically meaningful change of CAL on an individual tooth basis. The results of this study suggest that the placement of a bioresorbable collagen barrier has no significant effect on CAL in healthy areas.

A 10-year longitudinal study of untreated mucogingival defects.

A study was conducted to observe the changes in areas with untreated mucogingival defects over a 10-year period. The results in this group after 4 years were previously published. Upon entering dental school, a group of 39 freshman dental students were assessed for plaque index, gingival index, probing depth, and width of keratinized gingiva in 112 sites of inadequate keratinized gingiva. Eighteen of the original 39 participants were reassessed for the same parameters in 64 sites after 10 years. The results revealed that 22 sites showed a slight increase in keratinized gingiva, 32 were unchanged, and 10 sites showed a slight decrease in keratinized gingiva. The mean width of keratinized gingiva at the beginning of the study was 1.73 +/- 0.542 mm and was 2.01 +/- 0.864 mm after 10 years. This represented a small, but statistically insignificant, increase in the width of keratinized gingiva. The Plaque Index and Gingival Index of this group at baseline and at 10 years indicated a high level of oral hygiene and gingival health. It was concluded that in the absence of gingival inflammation, areas with small amounts of keratinized gingiva may remain stable over long periods of time.

Clinical evaluation of a biodegradable collagen membrane in guided tissue regeneration.

A bio-resorbable type I collagen membrane was investigated as a barrier for guided tissue regeneration. Ten human subjects with at least one pair of contralateral periodontal lesions with probing pocket depths of greater than or equal to 5 mm and radiographic evidence of greater than or equal to 40% bone loss were included. Each patient underwent contralateral surgical flap procedures. A collagen barrier was adapted to the tooth in the experimental defect and the flap replaced and sutured. The controls consisted of the same procedure without the placement of the barrier. Standardized measurements of change in probing attachment levels and fill of intrabony defects were obtained at the time of surgery and 1 year later at the time of surgical re-entry. The differences in change of probing attachment levels and amount of bone fill between individual test and control sites were compared utilizing the student's t-test for paired samples. The mean probing attachment gain in the test sites was 0.56 +/- 0.57 mm, and there was a mean probing attachment loss of 0.71 +/- 0.91 mm in the control sites (P less than 0.01). The gain of bone in test lesions was 1.16 +/- 0.95 mm, while no gain was observed in the control lesions (P less than 0.01). The results of this study demonstrated that sites treated with a collagen barrier comprised of cross-linked bovine Type I collagen exhibited significantly better healing as compared to control sites over the 1-year period of the study.